3

Question 1

How is and where is AF most commonly intiated

Answer 1

aberrant electrical impulses most often from pulmonary veins

Question 2

Rate of contraction in A-Fib is determined by?

Answer 2

AV node refractory period

HR in AF= 90-170 usually

Question 3

What determines the duration of QRS?

Answer 3

Bundle branch conductivity…thus bundle branch block = widened QRS

Question 4

Brain injury timeline

Answer 4

1) Red Neuron and neutrophils (24-48 hours)
2) Microglia (3-5 days)
3) Gliosis, cystic space surrounded by astrocytes (2 wks)

Question 5

Spleen embryologic orgin

Answer 5

Mesoderm of dorsal mesentery

However: blood supply is from splenic artery (foregut)

Question 6

Segmentation allows for…

Answer 6

Reassortment (BOAR)

Question 7

Irregular R-R, narrow QRS, absent P-waves

Answer 7

A-fib

Question 8

Periodontitis (often necrotizing) can be seen in what autosomal recessive disorder

Answer 8

LAD (absence of CD18)

Question 9

Infection following live vaccine

Answer 9

T-cell mediated immunity deficiencies (SCID and HIV for example)

Question 10

Wiskott Aldrich

Answer 10

Deficient cytoskeleton

Question 11

Anesthetics with high tissue solubility are characterized by large arteriovenous concentration gradients and _______ onset of action

Answer 11

slower

Question 12

Tropocollagen monomers self-assemble into collagen fibril and are cross linked by

Answer 12

lysyl oxidase

Question 13

Defect in post translation hydroxylation in RER leading to decreased triple helix stability of collagen

Answer 13

Scurvy

Question 14

what are the two components of advanced directives?

Answer 14

Living will and health care proxy (proxy must follow patients living will)

Question 15

microhemaggluttination assay-TP and FTA-ABS for T. pallidium remain positive for life. Track therapy with

Answer 15

VDRL and RPR

Question 16

shallow painful genital ulceration (chancroid) with regional LAD. Medium with hematin (X factor) useful in culture.

Answer 16

Haemophilus Ducreyi

Question 17

Nucleus in hypothalamus that monitors blood glucose

Answer 17

Ventromedial (VMN)

Question 18

Hypothalamic tumors in child

Answer 18

gliomas

Question 19

Nystan (polyene anti-fungal)

Answer 19

ergosterol pores (sim. to ampB)

Question 20

Acyclovir converted into

Answer 20

Acyclo-GTP inhibits DNA pol

Question 21

Viral infection in DM1 patient can lead to

Answer 21

DKA

Question 22

ventricular fibrillation in acute MI setting leading to SCD is due to what?

Answer 22

electrical instability in the ischemic myocardium

Question 23

Beta blockers in thyrotoxicosis

Answer 23

decrease sympathetics and decrease rate of peripheral conversion of T4–>T3

Question 24

Taste to ant. 2/3 of tongue

Answer 24

chorda tympani branch of facial nerve

Question 25

Posterior 1/3 of tongue taste

Answer 25

Glossopharyngeal nerve IX

Question 26

Posterior area of tongue root and taste buds of the larynx and upper esophagus

Answer 26

Vagus X

Question 27

Pneumococcal vaccine that induces T-cell-dependent B-cell response (higher affinity antibodies and memory cells)

Answer 27

Conjugated (diphtheria vaccine) PCV13 PPSV23 for adults= B-cell only...shittier

Question 28

Cholera vaccine

Answer 28

oral killed vaccine (need multiple inoculations and boosters)

Question 29

Oral typhoid and BCG

Answer 29

live attenuated vaccines

Question 30

Recombinant surface protein vaccine

Answer 30

HBV (similar effectiveness as killed)

Question 31

Inactivated toxin vaccines

Answer 31

Diptheria and tetanus (development of neutralizing antibodies against toxin)

Question 32

severe hypoplasia of marrow erythroid elements in the setting of normal granulopoiesis (white) and thrombopoiesis

Answer 32

PRCA

Question 33

Pathogenesis of PRCA

Answer 33

Inhibition of erythropoietic precursors and progenitors by IgG autoantibodies or cytotoxic T lymphocytes

Question 34

PRCA associations: | Note: ALL patients with PRCA need a chest X-ray

Answer 34

``` Thymomas (removal can cure) and lymphocytic leukemias Also parvoB19 (destroys proerythroblasts) ```

Question 35

Alpha-galactosidase A (FABRY) normally does what?

Answer 35

Breaks down globotriaosycleramine (Gb3); a sphingolipid also known as ceramide trihexose.

Question 36

Where can Gb3 build up in Fabry accumulate in kidney?

Answer 36

Glomerulus and distal tubule-->proteinuria and polyuria

Question 37

Accumulation of cerebroside sulfate

Answer 37

Metachromic leukodystrophy (Arylsufatase A deficiency)

Question 38

Lysosomal storage disease: Progressive demyelination leading to ataxia, peripheral neuropathy, seizures and hypotonia

Answer 38

Metachromic leukodystrophy

Question 39

Lysosomal storage disease: Optic Atrophy, developmental regression, seizures

Answer 39

Krabbe disease

Question 40

Anovulation is common when?

Answer 40

First several years of menarche and last few years of meopause

Question 41

Anaphylaxis in IgA deficient patient who wasn't wearing there dang medical alert bracelet

Answer 41

IgE antibodies directed against IgA (anti-IgA)

Question 42

Side effects of Acetazolamide (ex of use: open or closed angle glaucoma; it is decreasing HCO3 and AQH or in kidney blocks NaHCO3 and water reabsorption)

Answer 42

Somnolence, parathesias, alkalized urine...more rare: metabolic acidosis, hyponaturema, dehydration, hypokalemia

Question 43

Exchange of genes between 2 chromosomes via crossing over with homologous regions (Ex: nonsegment dsDNA viruses)

Answer 43

Recombination

Question 44

Uptake of naked DNA or in virology--> incorporation into host cell chromosome. Usually not passed on to progeny virions

Answer 44

Transformation

Question 45

Drain into the middle and superior rectal veins, which communicate with the internal iliac and inferior mesenteric respectively.

Answer 45

Internal hemroids

Question 46

Drain via inferior rectal vein into the internal pudendal-->internal illiac

Answer 46

external hemorrhoids